Frame running to confidence: the athlete-perceived impact of an adapted physical activity on aspects of physical fitness, functional mobility and psychosocial outcomes

Objective: Frame Running (RaceRunning) allows people with moderate-to-severe mobility impairments to participate in physical activity using a 3-wheeled frame with a saddle and handlebars. The aim of this study was to investigate athlete-perceived impact of Frame Running on aspects of physical fitness, functional mobility and psychosocial outcomes. Design: Survey. Participants: Frame Running athletes aged 5 years and over. Methods: A survey was distributed to athletes through their club or sports organization. Results: The survey was completed by 115 athletes (53 females). Median age was 17 years (range 5–62 years) and 64 (57%) used a wheelchair or walker for distances over 50 m. Many felt that Frame Running stretched their muscles (n=93, 87%) and increased their self-confidence (n=63, 93%). Four (4%) reported extreme fatigue or sore muscles after training (n=17, 15%). Of the 110 athletes who had been participating in Frame Running for over 3 months, 46 (47%) reported being less out of breath during mobility tasks and 66 (66%) felt they had improved their functional mobility. However, 7 (7%) reported increased muscle tightness and 4 (4%) reported a Frame Running-related injury lasting more than 4 weeks. Conclusion: Frame Running is a safe physical activity with athlete-perceived benefits on physical fitness, functional mobility and psychosocial outcomes.

Ultrasound Echogenicity as an Indicator of Muscle Fatigue during Functional Electrical Stimulation

Functional electrical stimulation (FES) is a potential neurorehabilitative intervention to enable functional movements in persons with neurological conditions that cause mobility impairments. However, the quick onset of muscle fatigue during FES is a significant challenge for sustaining the desired functional movements for more extended periods. Therefore, a considerable interest still exists in the development of sensing techniques that reliably measure FES-induced muscle fatigue. This study proposes to use ultrasound (US) imaging-derived echogenicity signal as an indicator of FES-induced muscle fatigue. We hypothesized that the US-derived echogenicity signal is sensitive to FES-induced muscle fatigue under isometric and dynamic muscle contraction conditions. Eight non-disabled participants participated in the experiments, where FES electrodes were applied on their tibialis anterior (TA) muscles. During a fatigue protocol under either isometric and dynamic ankle dorsiflexion conditions, we synchronously collected the isometric dorsiflexion torque or dynamic dorsiflexion angle on the ankle joint, US echogenicity signals from TA muscle, and the applied stimulation intensity. The experimental results showed an exponential reduction in the US echogenicity relative change (ERC) as the fatigue progressed under the isometric (R2=0.891±0.081) and dynamic (R2=0.858±0.065) conditions. The experimental results also implied a strong linear relationship between US ERC and TA muscle fatigue benchmark (dorsiflexion torque or angle amplitude), with R2 values of 0.840±0.054 and 0.794±0.065 under isometric and dynamic conditions, respectively. The findings in this study indicate that the US echogenicity signal is a computationally efficient signal that strongly represents FES-induced muscle fatigue. Its potential real-time implementation to detect fatigue can facilitate an FES closed-loop controller design that considers the FES-induced muscle fatigue.

From constraints to participation: A study of the behaviour of New Zealand travellers with mobility impairments

<p>Individuals with disabilities have been acknowledged in the literature to have the same desire to travel as their able-bodied counterparts. However, participation in tourism imposes disproportional challenges for many of them and there are still various areas that need to be improved. Research on travellers with disabilities is still in its infancy and most studies concentrate on barriers and constraints to participation. Not much is known about how these constraints are being dealt with and what influence they have on travel experiences of travellers with disabilities. This study explores the travel experiences of travellers with mobility impairments, with a focus on travel constraints and the negotiation strategies. This research draws upon the author’s personal experience as a traveller with mobility impairments who has faced travel constraints and tried to negotiate and overcome those constraints. I enjoy personal travel experiences and believe travel is a fundamental right for those with disabilities. Using an approach based on the social model of disability enhanced with a degree of human agency, this research was undertaken with travellers who have some degree of privileged status in terms of access to opportunities and resources required for travel. They voice concerns and problems, but they also demonstrate human agency which is significant for their travel experiences. The study seeks better insight into the tension between travel constraints and the ability of travellers with mobility impairments to participate in tourism. Constraints, negotiation strategies, and their influence on participation are addressed across different scales: the intrapersonal, interpersonal, and structural. A qualitative methodology informed by an interpretive social sciences paradigm enables this study to access people’s experiences expressed in their own words, give voice to them to get the meaning of social interactions, and thereby explain their travel experiences. Fourteen New Zealand-based participants aged between 18 and 44 were recruited, all of whom have either a congenital or acquired a mobility impairment. In-depth semi-structured interviews were designed with a staggered approach comprising three interview sessions with each participant. Overall, 42 interview sessions with 14 participants resulted in detailed data which was analysed using a content analysis approach. The analysis focused on the travel experiences of travellers with mobility impairments which span over degrees of participation: from non-participation to partial participation to full participation. This outlined the tension between constraints and negotiation and how the final levels of participation were impacted by that tension. Travel constraints, negotiation strategies, and tourism facilitators ‒ in three levels of intrapersonal, interpersonal, and structural ‒ affected the levels of participation. Sometimes participants used negotiation strategies from a different category than the constraint; for instance, an interpersonal negotiation strategy to overcome a structural constraint. The research confirmed many of the factors identified in the literature but revealed a greater range of constraints, facilitators and negotiation strategies, including some that have not previously been explored, for example, time (constraint), resilience and determination (facilitator), and developing emotional skills (negotiation strategy). The findings also revealed that some factors could influence participation with multiple roles. Equipment and money could be constraints, facilitators, and negotiation strategies in different travel experiences. Although generalized helplessness around travel was not observed in the sample, individual incidents of feeling a sense of helplessness had an effect on participation in tourism. Participants’ disability, more specifically the type and severity of their impairments, was another determining factor for participation. Lastly, the type of trip and destination were significant in terms of constraints encountered, negotiation strategies used, and the level of participation. Participants regarded business trips as the easiest (when compared to VFR and pleasure travel) with fewer constraints that generally were easier to overcome. Most participants also regarded domestic trips as easier compared to international trips due to their familiarity with the travel context. The research brings together the theory of negotiation, the theory of learned helplessness, and the leisure constraints model into a single study to understand different levels of participation among travellers with mobility impairments. Therefore, it contributes to an understanding of the travel experiences of travellers with mobility impairments in the New Zealand context and the implications of disabilities for travel. Hence, the research hopes to promote the changes required to improve the travel experiences of travellers with mobility impairments. Based on the theoretical and practical contributions of the study, several recommendations are provided for the tourism industry and the policy-makers. These recommendations aim at moving towards a more inclusive and fair tourism for travellers with disabilities.</p>

From constraints to participation: A study of the behaviour of New Zealand travellers with mobility impairments

<p>Individuals with disabilities have been acknowledged in the literature to have the same desire to travel as their able-bodied counterparts. However, participation in tourism imposes disproportional challenges for many of them and there are still various areas that need to be improved. Research on travellers with disabilities is still in its infancy and most studies concentrate on barriers and constraints to participation. Not much is known about how these constraints are being dealt with and what influence they have on travel experiences of travellers with disabilities. This study explores the travel experiences of travellers with mobility impairments, with a focus on travel constraints and the negotiation strategies. This research draws upon the author’s personal experience as a traveller with mobility impairments who has faced travel constraints and tried to negotiate and overcome those constraints. I enjoy personal travel experiences and believe travel is a fundamental right for those with disabilities. Using an approach based on the social model of disability enhanced with a degree of human agency, this research was undertaken with travellers who have some degree of privileged status in terms of access to opportunities and resources required for travel. They voice concerns and problems, but they also demonstrate human agency which is significant for their travel experiences. The study seeks better insight into the tension between travel constraints and the ability of travellers with mobility impairments to participate in tourism. Constraints, negotiation strategies, and their influence on participation are addressed across different scales: the intrapersonal, interpersonal, and structural. A qualitative methodology informed by an interpretive social sciences paradigm enables this study to access people’s experiences expressed in their own words, give voice to them to get the meaning of social interactions, and thereby explain their travel experiences. Fourteen New Zealand-based participants aged between 18 and 44 were recruited, all of whom have either a congenital or acquired a mobility impairment. In-depth semi-structured interviews were designed with a staggered approach comprising three interview sessions with each participant. Overall, 42 interview sessions with 14 participants resulted in detailed data which was analysed using a content analysis approach. The analysis focused on the travel experiences of travellers with mobility impairments which span over degrees of participation: from non-participation to partial participation to full participation. This outlined the tension between constraints and negotiation and how the final levels of participation were impacted by that tension. Travel constraints, negotiation strategies, and tourism facilitators ‒ in three levels of intrapersonal, interpersonal, and structural ‒ affected the levels of participation. Sometimes participants used negotiation strategies from a different category than the constraint; for instance, an interpersonal negotiation strategy to overcome a structural constraint. The research confirmed many of the factors identified in the literature but revealed a greater range of constraints, facilitators and negotiation strategies, including some that have not previously been explored, for example, time (constraint), resilience and determination (facilitator), and developing emotional skills (negotiation strategy). The findings also revealed that some factors could influence participation with multiple roles. Equipment and money could be constraints, facilitators, and negotiation strategies in different travel experiences. Although generalized helplessness around travel was not observed in the sample, individual incidents of feeling a sense of helplessness had an effect on participation in tourism. Participants’ disability, more specifically the type and severity of their impairments, was another determining factor for participation. Lastly, the type of trip and destination were significant in terms of constraints encountered, negotiation strategies used, and the level of participation. Participants regarded business trips as the easiest (when compared to VFR and pleasure travel) with fewer constraints that generally were easier to overcome. Most participants also regarded domestic trips as easier compared to international trips due to their familiarity with the travel context. The research brings together the theory of negotiation, the theory of learned helplessness, and the leisure constraints model into a single study to understand different levels of participation among travellers with mobility impairments. Therefore, it contributes to an understanding of the travel experiences of travellers with mobility impairments in the New Zealand context and the implications of disabilities for travel. Hence, the research hopes to promote the changes required to improve the travel experiences of travellers with mobility impairments. Based on the theoretical and practical contributions of the study, several recommendations are provided for the tourism industry and the policy-makers. These recommendations aim at moving towards a more inclusive and fair tourism for travellers with disabilities.</p>

Ushering in the Silver Age of Telehealth: Addressing Telehealth Disparities for Older Adults With Disabilities

One silver lining of COVID-19 has been the ushering in of ‘the golden age of telehealth’. However, this unplanned rapid conversion to telehealth left many providers and clinics unprepared to address systemic barriers that adversely affect older adults, particularly those with disabilities. Data from the VA Corporate Data Warehouse suggest that the rapid adoption of telehealth in mental health clinics during COVID-19 widened telehealth utilization disparities for older Veterans (65+) with disabilities. With 4.5 million Veterans 55+ who have at least one disability more attention to addressing this widening gap is needed. For those with hearing, vision, and complex mobility impairments, there are unique challenges to initiating telehealth services. Dr. Touchett will present preliminary findings while discussing ethical and contextual considerations when using telehealth with older Veterans who have disabilities, while discussing ways to facilitate robust clinical encounters for this population.

Use it or Lose it!

<p>In the foreseeable future, the elderly will make up a significant proportion of New Zealand’s population. The relationship between ageing and disability means the disabled population is expected to increase as the population ages. Physical disabilities especially mobility impairments have adverse impacts on the life experience of elderly people. The outdoor environment contributes to the physical and mental health of ageing people and can provide the opportunities to enhance their quality of life. This thesis explores the concept of a rehabilitative landscape design at Kenepuru Community Hospital. The design aims to improve and maintain mobility during the ageing process, and potentially provide feedback which will motivate the ageing to continue a healthy lifestyle. The thesis concludes that the “disabled” elderly and their community gain a better life experience while reconnecting with a strategically designed outdoor environment.</p>

Kinetic Values, Mobility (in)equalities, and Ageing in Smart Urban Environments

The idea of the right to mobility has been fundamental to modern Western citizenship and is expressed in many legal and government documents. Although there is widespread acceptance regarding the importance of mobility in older adults, there have been few attempts to develop ethical and theoretical tools to portray mobility (in)equalities in old age. This paper develops a novel conceptualisation of kinetic values focusing on older adults whose ability to move has been restricted for internal and external reasons. Informed by the phenomenological theory of kinaesthesia, I suggest that kinetic values are related to four principal dimensions: self-motion, being-moved, co-motion, and forced movement. I assume that these dimensions can address the key dilemma of human dignity among older adults who suffer from losing their autonomy and agency through their mobility impairments and who are at risk of being confined to their homes. To concretise the formulation of kinetic values, I study movement as part of technological equipment and urban infrastructure to examine what kinds of kinetic values mobility services and assistive robots convey for older adults in smart urban environments. By bridging disciplines, the phenomenological approach provides a novel understanding of mobility and the interplay among assistive technologies, kinaesthesia, and urban technological infrastructure. The approach suggests that kinetic values should be interpreted more comprehensively so that kinaesthesia can become better identified as a positive life-promoting practice.

Emerging accessibility solutions for physical and mobility impairments

Innovation has played a substantial role in the field of Accessibility to the Information Communication Technology (ICT) throughout the past decade. The impact of these groundbreaking achievements has been reflected throughout all industries including Accessibility and Inclusive Technologies. The technological breakthroughs in areas like miniaturized computer hardware (e.g. wearables, smartphones, etc.), Artificial Intelligence (AI), Deep Neural Network, Machine Learning, Robotics, and Internet of Things (IoT) have paved the way for innovative solutions to meet a wide range of needs for people with disabilities.

An Inertial Sensor-Based Gait Analysis Pipeline for the Assessment of Real-World Stair Ambulation Parameters

Climbing stairs is a fundamental part of daily life, adding additional demands on the postural control system compared to level walking. Although real-world gait analysis studies likely contain stair ambulation sequences, algorithms dedicated to the analysis of such activities are still missing. Therefore, we propose a new gait analysis pipeline for foot-worn inertial sensors, which can segment, parametrize, and classify strides from continuous gait sequences that include level walking, stair ascending, and stair descending. For segmentation, an existing approach based on the hidden Markov model and a feature-based gait event detection were extended, reaching an average segmentation F1 score of 98.5% and gait event timing errors below ±10ms for all conditions. Stride types were classified with an accuracy of 98.2% using spatial features derived from a Kalman filter-based trajectory reconstruction. The evaluation was performed on a dataset of 20 healthy participants walking on three different staircases at different speeds. The entire pipeline was additionally validated end-to-end on an independent dataset of 13 Parkinson’s disease patients. The presented work aims to extend real-world gait analysis by including stair ambulation parameters in order to gain new insights into mobility impairments that can be linked to clinically relevant conditions such as a patient’s fall risk and disease state or progression.